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[接触甲苯工人的体感诱发电位]

[Somatosensory evoked potentials in workers exposed to toluene].

作者信息

Stĕtkárová I

机构信息

Neurologická klinika ILF-FTN, Praha.

出版信息

Cesk Neurol Neurochir. 1991 Sep;54(4):215-9.

PMID:1809520
Abstract

The aim of our study was to evaluated by means of SEPs possible subclinical impairment of the nervous system during long-lasting toluene exposure. A group of 36 rotogravure printers (men, mean age 39.3 +/- 11.6 years) exposed to toluene from a polygraphic plant in Prague was investigated. The severity of toluene exposure was documented by the measurements of toluene concentration in the breathing zone air, by the toluene concentration in blood and by biological monitoring (urinary hippuric acid concentration). The duration of exposure was 0.1-41.0 (mean 12.0) years. Somatosensory evoked potentials (SEPs) elicited by stimulation of the median a tibial nerves, clinical neurological examinations and laboratory tests were performed on each worker. The results of SEPs investigations were compared with findings in a control group of 23 healthy men (mean age 31 +/- 10 years). Most of printers abused alcohol regularly. Peripheral conduction velocities in both extremities and central conduction time in case of lower limb stimulation were decreased statistically significant (P less than 0.05). All abnormalities of SEPs at peripheral and/or spinal and cortical levels were found in 8 cases, of these in 3 workers were found the SEP abnormalities of "central" type (the increased central conduction time at normal conduction values in the periphery). An impairment of all SEP pathways was found in 2 workers. Our results indicate an impairment in both central and peripheral parts of nervous system. Peripheral abnormalities could be interpreted as an incipient ethylic polyneuropathy and central abnormalities as an early sign of subclinical dysfunction at spinal and cortical levels due to toluene exposure potentiated by alcohol consumption.

摘要

我们研究的目的是通过体感诱发电位(SEP)评估长期接触甲苯期间神经系统可能存在的亚临床损伤。对一组来自布拉格一家印刷厂里36名接触甲苯的轮转凹版印刷工人(男性,平均年龄39.3±11.6岁)进行了调查。通过测量呼吸区空气中的甲苯浓度、血液中的甲苯浓度以及进行生物监测(尿马尿酸浓度)来记录甲苯暴露的严重程度。暴露时间为0.1 - 41.0(平均12.0)年。对每位工人进行了正中神经和胫神经刺激诱发的体感诱发电位(SEP)、临床神经学检查以及实验室检测。将SEP检查结果与23名健康男性(平均年龄31±10岁)的对照组结果进行比较。大多数印刷工人有规律地酗酒。双下肢的外周传导速度以及下肢刺激时的中枢传导时间在统计学上显著降低(P小于0.05)。8例发现外周和/或脊髓及皮质水平的SEP均异常,其中3名工人发现“中枢”型SEP异常(外周传导值正常时中枢传导时间增加)。2名工人发现所有SEP通路均受损。我们的结果表明神经系统的中枢和外周部分均有损伤。外周异常可解释为早期酒精性多发性神经病,而中枢异常可解释为由于饮酒加剧了甲苯暴露导致的脊髓和皮质水平亚临床功能障碍的早期迹象。

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